Discover Cosmetic Surgery

Excessive Superficial Liposuction

2012-01-29T13:07:00.000-08:00

Excessive superficial liposuction can produce significant cosmetic complications.

The use of the tumescent technique and microcannulas allows the surgeon to do liposuction more superficially and to generate smoother results than could be done with old-fashioned techniques that used larger cannulas.

Some surgeons mistakenly believe that scraping the undersurface of the skin with the liposuction cannula will cause the skin to contract.

There is no scientific evidence to support the theory that intentional injury to the skin by doing excessive superficial liposuction produces improved cosmetic results.

Excessive superficial liposuction can injure the superficial blood and lymphatic vessels located on the immediate undersurface of the skin resulting in significant complications including scars, lumpiness, permanent irregular coloration, and full necrosis (death) of the overlying skin.

Skin naturally contracts after liposuction because
1) skin naturally contains elastic fibers and
2) skin is relieved of the gravitational effect of subcutaneous fat, and
3) liposuction naturally results in contraction of the collagen in subcutaneous fat.

Surgeons who advocate superficial liposuction must be careful to avoid the performance of excessive superficial liposuction.

Common Causes of Cellulite and What You Can Do

2012-01-19T04:54:00.001-08:00

Age

While cellulite can start to appear at any time after puberty, it becomes more common after the age of 30. There are several reasons for this. To start with, from the age of 30, the average woman gains 4.5 - 6.8kg (10-15lb) of fat per decade, and the more fat you have on your body, the higher your risk of cellulite becomes.

Ageing also triggers the thinning of the top layer of the skin that covers the subcutis layer, making the bumpy fat more visible from the surface. Finally, over the years, collagen fibres start to harden. This means the septa, which tether the skin to the underlying muscle, start to shorten and the skin is pulled downwards - the cause of the dimpling which is visible on the surface.

Sedentary Lifestyles

Today, we walk an average of 3 km (8 miles) per day less than our grandparents did - and every element of the formation of cellulite is affected by that inactivity. For example, the less you move, the fewer calories you will burn off and the more likely it is that you will gain weight. Inactivity also slows the circulation - when we exercise we strengthen the heart and without that strengthening, circulation is likely to be slowed. The problem i even worse for the lymph. It has no pump to send it round the system. Instead it relies solely on the contraction of the muscles and if you don't move regularly,the lymph flow will slow down.

Excess Weight

In the UK, over 30% of women are overweight, while 24% are classed as obese. In the US, 35% of the population is deemed overweight, while a further 25% are obese. This picture is echoed over much of the western world. While it is true that cellulite does affect slim women, cellulite is fat and overweight people are more prone to it.

Smoking

While nobody has yet done conclusive research, it seems likely that smoking is a major contributing factor to cellulite. Smoking causes mass formation of free radicals, with millions entering the body with every puff. Also, researchers in Japan have found that smoking triggers the production of enzymes in the body called MMP (matrix metalloproteins). These chop up collagen fibres, causing skin to thin - and when this happens cellulite becomes more noticeable. And should your body try to repair that collagen, it is going to find it harder to do so, as smoking reduces the body's levels of vitamin C, the nutrient that is essential for the formation of collagen.

Other Toxins

There are a few other very common habits that may also contribute to cellulite, namely drinking too much alcohol, relying on caffeine and eating too many fatty or sugary foods. While it may not be correct to say that these things cause cellulite by clogging up the fat cells with their debris, it doesn't mean they're not involved in the formation. For starters, all of the above create free radicals and trigger stress on the lymph system. They also destroy some of the vital nutrients we need to actually burn fat off. For example, each cup of coffee knocks 6mg of calcium from your stores - and calcium helps convert cells from fat-storers to fat-burners.

Sunbathing

One of the nastiest factors in the fight against cellulite is that tanning - one of the few things that disguises the dimples - could actually be contributing to your problem. In high summer, it takes as little as four minutes of sun exposure for damage to start occurring to the collagen an elastin fibres under the skin. And just like the effects of ageing or smoking, this damage things the skin over the subcutis and makes cellulite much more noticeable. As well as this, exposure to too much sunlight dehydrates the skin and cellulite is also more noticeable on very dehydrated skin, as this causes it to become thinner and less flexible.

Discover how you can get rid of cellulite

Does Revitol Cream Really Get Rid of Cellulite?

2011-12-27T08:27:00.001-08:00

Revitol cellulite cream is a cream that is applied to the areas of the skin affected by cellulite.

Cellulite can be found on many places on the body, such as the abdomen, buttocks, hips and thighs. It has been described as fatty deposits caught in pockets of connective tissues which and are just below the surface of the skin. These pockets of fat become enlarged, encouraging the cells themselves to fill up more space whilst pushing up against the skin, creating a dimpled and lumpy appearance.

To check whether or not you have cellulite you can squeeze an amount of skin between your fingers or both hands and if the area puckers, then this is confirmation that you have some cellulite.

It is more common in women than in men especially over the age of 35. However as more and more younger women gain weight, not necessarily through pregnancy any more, they too are prone to cellulite.

There are many ways to remove cellulite or to attempt to reduce the appearance of cellulite, and some of these do include the more expensive surgery methods. Procedures such as suction-assisted liposuction, ultrasonic-assisted liposuction and 3D-superficial liposuctionall claim to be able to remove cellulite from beneath the skin, but they come with their risks and a big price tag as well.

If you're looking for cheaper options to reduce the appearance of your cellulite, then creams may be the answer for you. Again, there are many different creams on the market today all claiming to be able to get the same results, however some are better than others. They will all moisturise the skin but they cannot all destroy the fatty pockets beneath the surface of the skin.

Some cellulite removal creams or anti cellulite creams, though, are formulated in such a way that their natural ingredients can penetrate through the layers of the skin to treat the fatty deposits beneath, encouraging the metabolic process to speed up and reduce the fat itself.

Revitol cream is such a cream, and many users of it are extremely happy and satisfied with the results. Revitol cream is designed to reduce the appearance of cellulite and has the following benefits:

The cream is designed to rehydrate and tighten the treated areas, whilst it can also create an even the skin tone also.
It helps to encourage the renewal of skin cells, promoting a healthier look.
It removes toxins which can be stored within fat cells.
It minimises the size of the fat storage cells.
Encourages and improves the elasticity of connective tissue beneath the skin.
It helps to encourage and improve metabolism within the treated area, due to the content of algae extract and green T extract which break down the fat to encourage the formation of smoother skin tissue.
It can treat other skin conditions such as stretch marks, wrinkles, dryness and acne in addition to cellulite.

It contains 100% natural ingredients such as vitamins, green tea extract, aloe Vera, bladderwack (a type of seaweed), retinol A, caffeine and algae extracts.

Retinol A is a particular ingredient which is derived from the A vitamin. It helps to strengthen and condition your skin focusing on the connective tissues which lie just underneath the surface of the skin.

The ingredients within Revitol cream are absorbed into the fat cells beneath the skin, helping to dissolve them by speeding up the metabolic processes, thus helping to create a smoother healthier looking skin.

Another of the reasons that Revitol cream works so well is because of the ingredient caffeine. Drinking excessive quantities of coffee however will not give you the results you are after, as consuming caffeine through your mouth and ultimately your stomach, is not going to reach or target the fat cells which create cellulite in the first place.

Revitol cream contains a particularly intense and she for the of a concentrated form of caffeine, encouraging it to target specific cellulite affected areas.

Retinol A is another important Revitol component or ingredient within the cream, which is derived from vitamin A and which focuses on the connective tissues within the skin helping to decrease the pockets which cause cellulite, preventing it from getting any worse and giving the skin a more youthful appearance.

Whilst Revitol cellulite cream may claim to remove cellulite and cure you of cellulite, it can certainly reduce the appearance on any specific area. Cellulite is a long-term skin condition and Revitol can treat it continually so long as you keep using the cream itself on a regular if not a daily basis. Revitol can give you rejuvenated, healthier and more attractive looking skin as a result of regular use.

Finally it should be mentioned that Revitol offers a three month money back guarantee to anyone who is unhappy with the results.

If you are affected by cellulite on particular areas of your body, I would fully recommend Revitol cream to reduce and remove its appearance as a cheaper and effective way of reducing the appearance of cellulite.

I believe it works, as I have seen the results first hand.

If you prefer to look at surgery methods however, do your research first, find out everything you possibly can about cellulite whether or not liposuction or other surgical treatments for cellulite, can remove cellulite as well as plain old body fat.

Breast Enhancement Surgery - Check Your Physician's Qualifications

2011-12-27T07:56:00.001-08:00

When looking for a board-certified general or plastic surgeon to perform your breast enhancement surgery, it is advisable to evaluate and review appropriate providers of certain procedures as well as professional affiliations.

Board-certified plastic surgeons are suitable providers for procedures which are regarded as enhancement through plastic surgery of the breast, or procedures which will alter the appearance of, or even the shape of the breasts in any way.

These kinds of procedures include: breast enlargement, breast reduction, breast reconstruction, breast enhancement, breast lift, and surgical procedures to take care of flaws and deformities. In some instances, a cosmetic plastic surgeon might also perform procedures to remove cysts and breast tumors, breast-conserving surgery, lumpectomy, and procedures to remove the entire breast, including skin-sparing mastectomy and mastectomy procedures; although, these operations are more often carried out by a general surgeon. This is usually done in consultation with a plastic surgeon, in the event that reconstruction of the breast is proposed.

Suitable providers for procedures to identify or treat breast illness or disease, including procedures to remove breast cysts and breast tumors, biopsy, breast-conserving surgery, lumpectomy, as well as all forms of mastectomy, are board-certified surgeons.

Among board-certified general surgeons and plastic surgeons, professional affiliations include, more specifically, the organizations which assist the education, training, and research of plastic surgery or surgery generally, and of doctors attaining the right qualifications to undertake certain breast enhancement surgery procedures.

In addition, these organizations demand specific standards of practice, continuing medical training and eduction, and ethics, all with the objective of backing safety of the patients.

Board-Certified Plastic Surgeons

With regard to board-certified plastic surgeons, identify membership within the American Society of Plastic Surgeons (ASPS). ASPS demands that associates are board certified by the ABPS (American Board of Plastic Surgery), and requirements include additional continual training, education and competency and expertise in plastic surgery procedures. This organization furthermore demands that members adhere to basic safety specifications and also ethical standards including things like patient rights and privacy, and advertising.

The main professional membership for any board certified plastic surgeon is the American Society of Plastic Surgeons, however board-certified plastic surgeons can belong to sub-specialty groups. For instance, board-certified plastic surgeons who practice aesthetic plastic surgery (procedures designed purely for the intention of enhancing the appearance), may also belong to the ASAPS (American Society for Aesthetic Plastic Surgery).

Board-Certified Surgeons

The ACS (American College of Surgeons) is the professional organization for all surgical areas of expertise, which includes general surgery and plastic surgery. Members are defined by specialty. Like the American Society for Plastic Surgeons, the American College of Surgeons has membership conditions and continuing education specifications for their members in addition to ethical and safety requirements.

Physicians may also belong to sub-specialty groups. A professional group of surgeons formed the The American Society of Breast Surgeons, to promote research, to encourage the study of breast surgery, and encourage the development of advanced surgery methods and techniques, as well as to improve the standards of practice for breast enhancement surgery in the America. The Society of Surgical Oncologists is another professional group that includes physicians who are experts in the treatment of all forms of tumours.

Why Do I Want Cosmetic Breast Surgery?

2011-12-27T07:53:00.000-08:00

Desire, as in want, and need, are two completely different things, and are quite subjective to many individuals. To some, need is about desire, but it's not an absolute necessity in order to live.

To others, need is what they have to accept in order to survive. A lot of the focus with this subject is about what individuals want. It is about the wish to enhance or perhaps change the appearance of one's breasts so to achieve a personal aim. But wanting and desiring in actual fact is related to need in every situation. Even in the case of need, a woman still wants for particular results.

Why you may wish to undergo cosmetic breast surgery is a very big issue that you must consider and indeed that you must ask yourself, and be able to answer truthfully and realistically. No-one can answer the question for you, nor can anybody make the decision but you - only you.

In asking exactly why you want to have cosmetic breast surgery, you must establish your goals. Precisely what is it that you want to attain for your body as well as for your life? The solution to why you may wish to undergo cosmetic breast surgery will be based around understanding and knowledge of your condition, of any given procedure, as well as on the recommendations of the qualified surgeon.

Be realistic and sensible in what you believe you desire, that is, what you want to attain, and be sure to be realistic when seeking your reasons. Once you have determined the answers and what it is that you want, the questions don't stop there. Determining why you believe you want breast surgery is simply the first step in your whole journey and experience with breast surgery.

"Wanting to undergo breast surgery is one thing I joked about but continued to think about for a considerable amount of time. However, there came a day when accepting that I had gone from the fullsome 34C cup that I was to a 34A that I became after two pregnancies, wasn't something I really could joke about any more.

I would tell any woman - if you feel that you want to have a breast surgical treatment, that you will undoubtedly joke about, think about and possibly even be ashamed or embarrassed about wanting surgery, before you eventually find someone that you are able to confide in and speak with about it. Yet, whatever stage you are at, your answer as to the reasons why you want cosmetic breast surgery will be the same every time, and that is always "because I want it!"

However, you must do your homework and your research before undergoing something as serious as cosmetic breast augmentation surgery, and I recommend that you read:

1. Cosmetic breast surgery - risks and complications

2. Cosmetic breast surgery - augmentation and the 'internal bra system'

History of Cosmetic Surgery in the UK

2011-06-30T09:48:00.000-07:00

If we define cosmetic surgery as surgery that alters physical appearance, then nearly all human cultures from the Stone Age onwards seem to have adopted practices that altered the appearance of members of the tribe. In Kenya, marks on the face were made by cutting the skin and then rubbing in earth so that the resulting scar was wide and visible. The idea was that a member of any particular tribe was instantly recognisable. Many tribesmen and women had bones or other objects forced through noses and earlobes. They did this, or had this done to them, for the age-old reason that they wanted to fit in and look like other members of their society. This is pretty much the same reason why the majority of cosmetic-surgery patients today seek surgery.

Although it is true to say that cosmetic surgery is still a relatively new speciality in the UK„ it dates back for centuries. The beginnings of eyelid surgery can be traced back to the 10^thcentury in Arabia. The first record of a facelift was in the early 1900s, although it is not known who attempted the very first one.

As early as 600 BC, the first evidence of nose reconstruction (rhinoplasty) was recorded. By the end of the 1^st century, rhinoplasty was common as a result of the uncivilised practice of cutting off the noses and lips of one’s enemies. By the 16^th century, noses were reconstructed after being severed in duels by using flaps of upper arm skin: necessity was the mother of invention!

Otoplasty (correction of protruding ears) was described in the 1850s, although there is some evidence to show that it was performed much earlier. The first breast reduction can be traced back to the 15^th century, while the first silicone implant for breast augmentation was performed in 1963. Prior to that, breasts were enlarged using dermal (deep layer of skin) grafts and even injecting liquid silicone, a practice that was short lived because of the disastrous consequences. The injection of liquid paraffin was also tried at various times since 1889, but the results were poor and the complications horrendous.

The most modern revolutionary cosmetic surgical procedure dates back to the early 1970s when surgeons in Switzerland described for the first time a technique for sucking out fat. The initial trials were not a total success because of the frequency of postoperative complications, notably seromas (large accumulations of fluid under the skin), which took a long time to absorb, and skin depressions. In 1977, a French surgeon, Gerard Motu, perfected the technique by using a blunt cannula (surgical tube) connected to a high negative pressure vacuum pump.

In most countries of the world, when a doctor qualifies as a specialist he sets about establishing a practice. There are various professional ways to do this. The usual way is to inform all of his colleagues that he is available to receive referrals relevant to his speciality, and he also sets about telling as many people as possible what he does and how to find him. Hopefully, sooner or later his reputation grows and his practice increases. Some specialists buy into already established practices as a junior partner and in many countries it is possible to buy a practice from someone who is retiring.

After the inception of the NHS in Great Britain in 1948, the system became quite different. It was only possible to set up as a specialist once one had been appointed a consultant. The supply of consultant posts was wry restricted, so a doctor only became a consultant when a post became vacant. There were always very many more trained doctors than there were posts available.

Doctors who became consultants under this system claim that only the best were chosen, but this was not always the case, as many doctors became disillusioned and either gave up hospital medicine or emigrated. It also meant that, in Britain many fully trained doctors could not get consultant posts and remained so-called junior doctors well into their 40s. This led to the concept that doctors who trained in the NHS needed 14 years or so after qualification to become adept in their speciality. The rest of the world did not believe this and overseas specialists became fully qualified at a much younger age.

The reason for the late appointment of consultants in the NHS was the bottleneck created by the lack of posts available. The training of junior doctors was generally on-the-job training, in an ad hoc fashion, more like an apprenticeship. Often there was no formal training; a junior doctor had to serve his time and hope that a consultant post became available when he was sufficiently senior.

In the NHS in the 1970s there was no formal training in cosmetic surgery. There still isn’t really, because very few purely cosmetic operations are performed in NHS hospitals. Nearly all cosmetic surgery is done in the private sector. Both the authors left the NHS and gained their training by following senior surgeons who had busy private practices.

Plastic surgery was established as a speciality only relatively recently, after the Second World War. Plastic surgeons claimed cosmetic surgery as part of their speciality, but in reality many different types of surgeon have been performing cosmetic surgery for over 150 years. It is not true that plastic surgeons are the only ones who are fully qualified, as they claim, to carry it out. Their own training programme has only recently embraced cosmetic procedures. They spend most of their time carrying out operations on burns, malformations and injuries and their training reflects this. It is quite common even today for a plastic surgeon to become a fully qualified specialist with virtually no experience in cosmetic surgery.

There is little common ground between the usual NHS plastic-surgery patient and those seeking a cosmetic operation. Cosmetic patients are generally much more exacting in their expectations than those who need cancer surgery or skin grafting for burns.

There used to be a total prohibition on any form of advertising by doctors. This was designed to protect vulnerable patients from blandishments from unscrupulous doctors. In reality, it protected and controlled the referral system of private patients by GPs to hospital consultants. Up until the 1970s it was never imagined that this ‘in-house’ system could or would be challenged by anyone. But challenged it was, by a group of entrepreneurs who took advantage of a legal loophole that allowed non-medical people to set up independent private medical services, which then employed surgeons and anaesthetists.

These entrepreneurs had only one thought in mind; medical ethics were certainly not high on the agenda. They were not regulated by any ethical body, and were therefore allowed to publicly promote and advertise medical services in the media. As a result private medical services began to be established offering abortions, medical screening and cosmetic surgery.

Some unscrupulous individuals saw this as a passport to making easy money and established some of the first cosmetic surgery clinics in the 1970s. Many employed hard-sell tactics and adopted the attitude that they were beyond reproach as any mishap could easily be blamed on the doctor. Therefore, they would refuse to take any responsibility in the event of a problem. These individuals quickly gained control of the cosmetic-surgery industry.

Unfortunately, many doctors did not approve of cosmetic surgery in any form and refused to refer their patients. This meant that many patients had no way of finding a surgeon who performed cosmetic surgery unless they contacted one of these clinics. Since that time the number of these clinics and establishments in the UK has grown enormously, particularly since 2001. Every major town and city has several different providers in competition with one another.

As a result of the activities of commercial clinics, the rules on medical advertising have now been very considerably relaxed and numbers of doctors appear in the media hawking their skills. Often they are the same doctors who only a few years ago accused surgeons who worked for commercial clinics of being unethical.

Advertising is still generally disapproved of by most of the profession. However, in Britain today, the majority of cosmetic operations are performed by doctors working for commercial clinics. These clinics have a financial imperative to carry out as many operations as possible and, certainly in the past, dubious methods were used to get patients to sign up. It is however commercial suicide to run an unethical clinic and most, but by no means all, clinics these days treat their patients with consideration and skill. There is still a risk, however, that a vulnerable patient may meet a salesman or woman paid on commission who will say virtually anything in order to get them to undergo treatment.

Whatever the criticism of cosmetic surgery in the past, one thing is patently obvious: in expert hands it is extremely successful and has transformed the lives of many people for the better. It is here to stay and is growing very quickly.

Cosmetic Surgery: General Considerations

2011-06-30T03:26:00.000-07:00

General Considerations

Cosmetic surgery can be defined as ‘that branch of surgery whose primary aim is the enhancement of the non-pathological external appearance of a patient’.

In cosmetic surgery perfection is the aim, rarely the achievement. What may be deemed an acceptable result by one patient may be totally unacceptable to another. The realistic aim of cosmetic surgery therefore is to improve the appearance of a particular feature or deformity with the intention of achieving increased self-satisfaction and self-confidence.

Those expecting a miracle or a result that is outside the realms of surgical possibility will doubtless be disappointed. A particular surgeon may be unable to match what a patient has in mind regarding the final appearance. On occasions it may transpire that the goal of the patient would not actually suit him or her, or prove to be disappointing, even if attained.

The successful result of any cosmetic surgical procedure thus depends not only on the skill and experience of the surgeon, but also on a number of factors outside the surgeon’s direct control. These factors include the patient’s general health, age, skin texture, bone structure, healing properties, and the expectations of the patient. These can all influence the final result.

It is possible for complications to occur that in the short term can spoil a result. Complications occur in all branches of medicine and surgery, and are often outside the control of the medical practitioner. Occasionally, a patient may be directly responsible for causing a complication either through carelessness or not following postoperative instructions.

The success or failure of any cosmetic surgical procedure therefore is measured by one factor and one factor only, namely: ‘Is the patient happy with the result?’ Independent opinions count for nothing if the patient is dissatisfied.

Although a trained and experienced cosmetic surgeon is a highly qualified medical practitioner, he is not a magician, and is limited by the materials at his disposal. A person who is of moderate attractiveness cannot be turned into a ravishing supermodel by a nose-reshape operation, for example!

Not every prospective patient will be accepted for surgery. Sometimes it is in the patient’s best interests to be refused surgery, especially if the result could turn out to be less than satisfactory or, worse still, turn out to be worse than the previous situation. This can occasionally occur.

At the consultation a good surgeon will attempt to assess the patient psychologically as well as physically. This is to help him or her decide if the expected or usual result of the procedure is likely to please the patient. On rare occasions a cosmetic surgeon may refer a patient for a psychiatric opinion before deciding whether to operate. Cosmetic surgery is not a panacea or cure-all for all of life’s problems.

The ideal patient must be sufficiently self-motivated to undergo cosmetic surgery. If the desire for cosmetic surgery has been initiated by the ‘encouragement’ or persistence of a friend, relative or spouse, the end result is more likely to be a disappointment for patient and surgeon alike. It is difficult enough to satisfy and please one patient, let alone their partner and friends as well.

It is extremely unusual to encounter a patient who is not nervous or apprehensive about undergoing cosmetic surgery. This is only natural. Every surgical procedure, even a simple one such as a tooth extraction, entails some degree of risk. There may be complications, and the results may not match expectations.

The Need for Cosmetic Surgery

2011-06-30T03:19:00.001-07:00

We have learned from experience that even stunningly attractive people find fault in their appearance, often exaggerating their problem when it may seem negligible to the average onlooker. It is difficult to explain the reasons for this, but it is possible that this particular group of people set themselves very high standards from an early age and are so preoccupied with their appearance that, the moment they perceive a deterioration, they immediately seek help.

Learned psychologists will attempt to explain this phenomenon as a personality flaw. Many psychologists still denigrate cosmetic surgery as unnecessary and attempt to explain any strong reaction to a blemish as a deep-rooted mental aberration. But, despite all the complex jargon and scientific research conducted in an attempt to explain it, they are unable to offer a simple treatment or cure that will satisfy those afflicted with an abnormal obsessional disorder pertaining to their physical appearance. In our experience, attempting to convince a patient that her nose is pretty when she is convinced it is not, simply does not work.

Most people we meet in our practice every day are perfectly normal individuals who simply dislike a particular part of their anatomy, and would like it improved. In the vast majority of cases, the results of surgery are very successful and the patient resumes a normal lifestyle with renewed confidence.

There is no doubt that there are those who will never be happy with their appearance no matter what. These people can usually, but not always, be spotted by the experienced surgeon, and the only ethical response is to refuse them treatment. The surgeon may then refer the patient for counselling, really the only alternative when surgery will undoubtedly prove unsatisfactory.

How successful counselling may eventually prove will depend on the expertise of the counsellor and the seriousness of the person’s condition. One thing is certain – no amount of counselling can remove a physical blemish! As to whether someone can be persuaded that they do not really have a problem, when for years they have despaired of their particular blemish, is a matter for debate. We have certainly not encountered a case where this has happened. Conversely, however, we have both seen patients who have been cured of psychiatric problems by having successful cosmetic surgery.

It is hard not to feel pressure to look one’s best. Media coverage constantly exposes women to pictures of beautiful women, and advertising for beauty-enhancement products. Add to this any active criticism of a blemish an individual may have received from those around them, and a person can feel surrounded by reminders of their physical imperfections. Realistically, adults are no different from children in this respect. We have even encountered patients who were not ridiculed as children, but only when they became adults. All this leads to an ever-increasing sense of self-deprecation.

Early Childhood

Problems can start early in life if classroom bullying and teasing is rife. A common example is the child with protruding ears. Such teasing can lead to serious consequences for both child and parents. The child will detest going to school, become withdrawn, unhappy and depressed. His or her early developmental progress at school may be seriously compromised. The parents will suffer likewise, very often at a loss as to how to solve the problem.

Ears are fully developed by the age of five and a simple operation, at that stage can alleviate a lot of potential psychological damage in the future.

Adolescence

The next stage is the adolescent going through puberty. This is the time when many teenagers experience the onset of acne, which may be quite disfiguring. Other problems that occur at this time include problems with the development of secondary sexual characteristics e.g. breast-development in girls. This is often a time of turmoil for many teenagers who constantly strive to look their best and comply with the latest fashion trends in order not to be the odd one out.

We are now operating on more younger people than before. Schoolgirls will seek breast enlargement to avoid ridicule by their peers. Some will refuse to attend sports activities because it means undressing in front of classmates and changing into sports kit. Nose reshaping is also becoming more frequent in teenagers, as is liposuction. However, we do not feel that cosmetic surgery should generally be offered to teenagers unless the problem is particularly severe.

Early Adulthood

At the age of 18, most females have reached full physical maturity. They stop growing and have fully developed sexual characteristics, facial features and body shape. This is the time when a general overhaul of aesthetic appearance takes serious priority.

In the majority, if adolescence precluded seeking or establishing a relationship with the opposite sex because of the usual restrictions, early adulthood, with its new freedoms, can make up for the shortfall At this time most will be seeking to look their best in order to attract a partner.

Cosmetic surgeons will see patients in their young adulthood who will request nearly all the commonly available procedures, apart from those specific to reversing the aging process.

Middle Age

This is the next category of self-referral for cosmetic surgery. By this time most women will have had children. The early signs of facial aging will also be taking their toll.

A woman might complain of smaller, drooping breasts; a loose, flabby abdomen, and varicose or thread veins as a result of childbearing. The more children she has had, the more pronounced the problem. In addition she will probably have put on weight and be concerned about her facial appearance, particularly if she has been a heavy smoker for many years. She may therefore be seeking facial fillers and Botox®, as well as surgery.

Over the years, we have observed that many women request a facelift at the age of 50 and satisfy themselves that by doing this at that age it will last them until old age when they will not be concerned about their appearance. Many do not realise that they will still strive to look their best even at 70 because mentally they will probably feel the same as they did at 50. We often see women coming back ten years later for a repeat procedure.

Old Age

The majority of patients at this age are women who are mostly concerned with facial and eyelid aging. In addition many will request facial fillers and Botox® even though at that age fillers and Botox® will have very limited beneficial effect By this stage many will not be physically fit for surgery or not even be particularly concerned about their appearance, electing instead to grow old gracefully. Only those who are in good health will be operated on.

Conclusion

Although the concept of beauty is difficult to define precisely, one thing is for certain: with ever-improving and developing technologies, most women can rest assured that a great deal can be achieved to enhance their aesthetic appearance and thereby bring increased self satisfaction and self confidence.

The perception of beauty is ultimately a matter of personal taste and opinion. One thing is for certain — if we all had the identical concept of beauty all men would be attracted to the same women and vice versa, leaving many disappointed individuals overlooked. It is patently obvious that we have been designed to hold diverse views and opinions on what we find beautiful so that the human race can continue to procreate and survive.

Are You Considering Cosmetic Surgery?

2011-06-30T03:17:00.001-07:00

Cosmetic surgery can achieve almost unbelievable results. It has never been so popular and accessible, and celebrity endorsement has made it top of the wish list for not just the rich and famous, but for ordinary people as well.

But whether you are contemplating a simple Botox treatment to iron out your wrinkles, liposuction for troublesome areas of flab, or a more major procedure on our breast or face, it should never be undertaken lightly.

When a patient's expectations are unrealistically high or when inexperienced surgeons, employed by less reputable clinics, are let loose on an unsuspecting public, disappointment or even disaster can ensue.

It is always vital that the right surgery is done for the right reason, on the right patient, by the right surgeon. It is also imperative that sufficient time is devoted to preoperative counselling, so that informed consent can be given and the patient is fully aware of what to expect.

We live in a world where most media coverage of the subject is either journalistic hype, corporate advertorial or blatant scaremongering. It is difficult to know what to believe.

What is a Surgical Operation?

A surgical operation is a controlled injury and the body reacts to it like it does to any injury. Cosmetic surgery is not just about undergoing a surgical procedure, however. Before any patient is subjected to the physical injury of an operation, many other factors have to be considered. Indeed, we are firmly of the opinion that the preoperative considerations and preparatory events leading up to the big day when the surgeon makes the first incision, are equally if not more important, than the actual operative procedure.

Many people who undergo cosmetic surgery have never been in hospital before and are understandably frightened by the prospect. Some are more afraid of having a general anaesthetic than undergoing the operation itself. Fear of the unknown is natural and forever present in the field of surgery.

A fully informed patient is far more likely to be less apprehensive about undergoing surgery, be less nervous on the day of surgery and more likely to accept and come to terms with the possible, common postoperative events that are likely to be encountered. A fully informed patient is forewarned and therefore forearmed to face any possible eventuality. This can only be of benefit to the patient (as well as the surgeon and his staff).

Cosmetic Surgery: The Concept of Beauty

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Beauty is in the Eye of the Beholder

Since the dawn of history, men and women have attempted to modify their appearance to comply with the cultural standards of the era.

There are many philosophical theories to explain this concept but it doesn’t take a genius to work out that a physically attractive man and woman are more likely to get married or find a partner (as they are more sought after by the opposite sex), get better jobs and generally be more confident and successful.

Although it is not possible to define beauty easily — it varies with different cultures and is dependent on the eye of the beholder — there are certain physical characteristics that are significant for the overall ideal concept of beauty.

It is commonly said that the ‘ideal woman’ has a small chin, delicate jaw, large lips, small nose, prominent cheekbones, large and widely spaced eyes and a waist-to-hip ratio of 0.7. The ‘ideal man’ is tall, has rugged macho features — rectangular face and chin, deep-set eyes, heavy brow, large straight nose in proportion to the size of the face — and a waist-to-hip ratio of 0.9.

It is common for men and women to try to accentuate the differences between them. For instance, women are generally less hairy than men, so go to a lot of trouble to make sure that they are even less so. They also have softer skin than men and there is a huge industry devoted to selling women’s products that will soften the skin and protect it from becoming weather beaten and therefore more ‘masculine’.

Interestingly, sexual attractiveness and the concept of beauty are not necessarily the same thing. Attractiveness for a woman usually means that she looks healthy and is of a fertile age. When a man says a woman is attractive and ‘sexy’ he is observing the signs of possible fertility. Every ‘Miss World’ who has ever won the contest has had the waist-to-hip ratio of 0.7. Research has shown that women who have this ratio are more fertile than those that don’t.

When a woman finds a young man attractive she is often seeing the signs caused by testosterone, the hormone that makes a man masculine (and more fertile). If she finds an older man attractive, she is (possibly subconsciously) seeing a man who may be able to provide for her and any children she might have.

Detailed and accurate measurements of facial features and angles have tried to add a more scientific element to the concept of beauty. When these measurements are analysed and applied to different ethnic groups, those considered to be good looking or beautiful comply with universal scientific concepts of beauty. Thus, in the main, a particular ethnic beauty will still be considered attractive by the majority of any other ethnic group.

Many studies have stressed the importance of facial symmetry. No human face is exactly symmetrical, but marked asymmetry – beyond what is considered normal – is not usually considered to be beautiful. This is probably because of the association of good symmetry with good health.

Asymmetry is sometimes caused by sleeping on one side more than the other. Most people prefer to sleep on one particular side, a pattern that is established early in life. Babies tend to sleep a lot and grow while they are asleep; the side that is on the pillow doesn’t grow as much as the uppermost side. This means that, when an adult has one side of their face that is smaller than the other, it is possible to guess on which side they prefer to sleep.

At the same time it must be stressed that although facial appearance is a very important parameter when considering the concept of beauty, other bodily features are also important. These will include height, shape, amount of fat distribution on the body, breast size and shape, skin quality and so forth. A man or woman may not be particularly facially attractive but have a near perfect figure, and vice versa.

Of course, you have to add a person’s personality, or ‘inner beauty’ into the equation. Plenty of beautiful people get married, only to separate soon after. Physical attractiveness does not necessarily guarantee a long-term relationship, and in some ways can even detract from it.

Whatever may be analysed by philosophers and experts regarding the concept of beauty – and much has been said and written on the subject - the truth remains that many people are never satisfied with what Nature gave them in terms of their physical appearance.

Cosmetic Surgery: Pre-Operative Considerations

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In order to get the best possible result for a particular patient it is extremely important to strive to attain the best possible conditions in which to operate. It is our opinion that the pre-operative consultation is the most important part of the entire cosmetic procedure, and has been discussed in more detail in the previous section. This section deals with the physical and medical aspects of the fitness of a patient for surgery.

Because cosmetic surgery is entirely elective, it is of paramount importance for the surgeon to ensure that you are physically fit to withstand the operation safely and without undue risk. It would be extremely foolhardy for a surgeon to operate on any patient who has an increased risk of a serious medical complication following a procedure, which may endanger her well-being.

A carefully devised pre-consultation questionnaire is a useful tool to screen a patient from a purely medical perspective. This will usually give the surgeon all the information he requires in order to ascertain if you are physically fit for surgery, or if there are any factors that may preclude proceeding. Any grey areas can then be investigated in more detail.

In addition, the surgeon will go through his own, thorough screening routine to ensure that it is safe to operate on you. Some of the more important points to consider are as follows.

Your Current General Health

Any significant history of current problems with medical fitness will immediately alert the surgeon to take appropriate action and make an informed decision regarding proceeding with surgery. You should report any recently encountered symptoms, eg. excessive thirst, frequency of passing urine, unexplained weight loss, as these may signify the onset of an illness that has previously been undiagnosed, such as diabetes.

Past Medical History

A detailed past medical history should help uncover any contraindications to proceeding with surgery or alert the surgeon to any possible post-operative problems eg. previous post-operative deep vein thrombosis, or a history of heart or chest problems.

You should declare any past psychiatric history, with accurate details of any hospital admissions and medications prescribed. A past history of depression or anxiety can be very relevant to how you react to the stress of having an operation.

Family Medical History

And you most Any significant family history of illness should be declared, especially a family history of anaesthetic problems. A condition known as Malignant Hyperthermia is a familial disorder, whereby the sufferer's metabolic rate is grossly enhanced when under a general anaesthetic leading to a grossly exaggerated and rapid rise in body temperature, which, if not promptly and expertly treated, can lead to the rapid demise of the patient. Thankfully, this condition is extremely rare.

In fact, you should declare any disease or illness that you know runs in your family, no matter how insignificant you think it to be.

Allergies

By the time a person reaches puberty, she should be aware of any allergies she may be suffering from, especially to conventional drugs. The commonest, most important and pertinent allergen in surgery is Penicillin. Obviously an allergy to any other drug or medication is also important, especially to a particular anaesthetic agent or post anaesthetic drug, but this is less common. All allergies should therefore be declared prior to surgery.

Current Medications

It is important to inform your surgeon of any oral medications you may be taking, in case they are likely to react with any medication likely to be given during an anaesthetic or at any time in hospital. Of particular importance is the oral contraceptive pill and hormone-replacement therapy, as in some situations it will be necessary to take extra steps to protect the patient against the possibility of post-operative deep vein thrombosis.

You should also declare any homeopathic, alternative or other medicines or preparations to the surgeon and anaesthetist before surgery. These too can interact with conventional medicines, especially anaesthetic drugs, which could have disastrous consequences.

Abnormal Healing/Scarring

A history of abnormal scarring or healing should prepare you and your surgeon for the possibility of an unfavourable result. Everything possible should be done in an attempt to minimise this complication eg. your strict adherence to post-operative instructions, and measures for the prevention of infection.

Vitamins

The taking of vitamins is encouraged in order to enhance healing. The homeopathic preparation arnica is recommended by many surgeons as an aid to healing, although some scientific reports have cast doubt over its effectiveness.

Bleeding/Clotting Disorders

Any bleeding tendency or abnormal clotting disorder in you or your family must be fully investigated before surgery. Prior to surgery, many patients complain of 'bruising easily'. This is usually a harmless disorder, often referred to as 'devil's pinch', and is not significant.

If you or your relatives have previously experienced deep vein thrombosis following surgery, you should be treated with the utmost care and given prophylactic preventative therapy prior to surgery.

An increasing number of patients are travelling long distances by air to undergo cosmetic surgery. There is an increasing number of fatalities from pulmonary embolus in patients who have recently stepped off a plane and gone straight into an operating theatre for surgery. Extreme caution should always be exercised in these circumstances.

Excessive Alcohol Intake

Excessive alcohol intake will impair liver function and therefore the production of the essential clotting factors in the blood. This can sometimes cause a problem if the clotting time is increased after the operation. This can in turn lead to excessive post-operative bleeding with the increased likelihood of developing a post-operative haematoma.

Aspirin, a common drug taken for a variety of reasons, has a similar effect on bleeding, and should be avoided for two weeks prior to elective surgery if at all possible.

Smoking

All patients are strongly encouraged to stop smoking. Smoking is not only a recognised health hazard in its own right, but is responsible for a number of post-operative problems and complications in patients who have a general anaesthetic for elective cosmetic surgery.

1. Impaired circulation

It is a known fact that heavy smokers are more liable to suffer the consequences of impaired circulation. This can lead to flap necrosis (loss of the skin resulting in noticeable scars) eg. following a facelift or abdominoplasty. The rate of healing will also be affected. In addition, a smokers cough immediately following facelift surgery can easily precipitate a haemorrhage and an expanding haematoma.

2. Chest infections

Heavy smokers are more likely to develop a chest infection post-operatively, particularly after major procedures such as abdominoplasty.

Anaesthetic Reactions

This has already been mentioned above. Individual patients react differently to a general anaesthetic. Some suffer excessive vomiting, some find it difficult to wake up afterwards, some wake up very tearful, but luckily most get no side effects at all.

In many cases you will be aware of a particular reaction you have to an anaesthetic agent from previous experience. Any untoward reaction to an anaesthetic agent must be dealt with promptly and, thankfully, serious complications are rare. Any known anaesthetic reaction must therefore be declared prior to surgery.

Most local anaesthetics contain adrenaline. The function of the adrenaline is to cause vasoconstriction (narrowing of the local blood vessels) thereby reducing bleeding at the operation site. This makes it a lot easier for the surgeon to operate.

In the main, allergies to local anaesthetics are extremely rare. However, some people can occasionally develop an unpleasant feeling immediately following the injection of a local anaesthetic, which is attributable to the adrenaline. This reaction is usually short lived.

Urinary Problems

Urinary tract infections are a common post-operative complication, especially in patients who are prone to them.

Abstinence from Food and Drink

Every patient undergoing a general anaesthetic must abstain from food and drink for several hours beforehand. This is to ensure that the stomach is empty in order to prevent the inhalation of vomit during the administration and duration of the anaesthetic. Each patient will be advised accordingly.

Employment and Social History

One of the commonest questions patients ask after surgery is, 'When can I go back to work?' The surgeon will need to know what your work commitments and circumstances entail in order to answer this question accurately. Depending on the scale of the procedure you are considering, you may need to arrange to have some considerable time off work. Only you will know if this is feasible. Your relationship with your work colleagues — whether you get on well with them or not, whether they know about and are sympathetic towards your having surgery — can also have an important bearing on how successfully you view the result.

Ideally you will have a loyal and supportive partner or close friend who will help you through the inevitable stress of having surgery and coping with the immediate effects. Often the result of surgery initially is quite disappointing. At first the patient just sees the effect of an injury: bruising, swelling, scars and stitches. It is only later that the beneficial effects of the operation become apparent. It is very helpful to have personal support through these early stages after an operation.

The second best situation is to be left alone to recover quietly without having to look after anyone else except yourself. The worst situation is to live with a partner who is antagonistic to the whole idea of the operation. Every little bruise could be the focus of an 'I told you so' type of remark, and an operation that would have been a success with a supportive partner can be turned into a failure.

It is a good idea for a husband and wife to attend the pre-operative consultation together if possible, so that the events in the post-operative phase and all the complications and risks can be explained to them both at the same time. This is particularly pertinent to breast surgery and skin resurfacing procedures of the face.

Your Hopes and Expectations

One of the most important questions the surgeon should ask you is, 'What are you trying to achieve?' He then has to compare your answer to what you are actually likely to get. If you are hoping for rather more than the procedure is generally capable of achieving, then disappointment is very likely.

The ideal patients for cosmetic surgery are physically healthy, emotionally sound and want what the operation can usually provide. A supportive home and work environment also make a big difference.

Risks of Cosmetic Surgery Procedures

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Here, we deal with those post-operative complications that can occasionally occur with any surgical procedure. Complications, which are peculiar, specific or unique to a particular procedure, are discussed in more detail within the relevant entry.

The human body is a very complex entity. Despite our current knowledge, we are still only scratching the surface with our understanding of the many intricate mechanisms of its functions and behaviour. We have limited understanding and therefore limited control over the complicated healing process that starts once we down tools.

We rely on the intricate biological, physiological and immunological systems to interact in a controlled and synchronised manner to heal the tissues and give a pleasing cosmetic result with the minimum of scarring or tell-tale signs of surgery. We expect our bodies to do all this despite the magnitude of the physical assault inflicted by the surgery.

The complex mechanism of the healing process is usually the patient's best friend. If all goes according to plan, an area that has been operated on will heal quickly with the minimum of bruising and swelling, leaving a thin scar, barely visible to the naked eye.

On the other hand, the opposite can occur, through no fault of the surgeon, and the operated area may become excessively bruised with permanent pigmentation, persistent swelling or thickening of tissues and a very visible disfiguring scar. At worst, the post-operative appearance may be more disliked by the patient than the pre-operative: Revision surgery may be required in an attempt to improve the final result. Thankfully this doesn't happen very often in experienced hands but, when it does, it understandably causes the patient and surgeon concern.

Every surgical procedure carries a risk, even if performed by the world's best surgeon. It is therefore important for everyone who is contemplating cosmetic surgery to be fully aware of the possible complications that may occasionally occur. This will lessen the psychological trauma and disappointment should anything go wrong.

Nervous patients may be unhappy to take the risk of surgery once they have been informed of all the possible consequences. Bolder ones may be perfectly happy to proceed. In either case it is the patient's decision, and an ethical surgeon has a duty to give a balanced account of all the risks. In conventional surgery, a surgeon may well try to persuade a patient to have an operation because he believes it is in their medical interests to go ahead. The benefits to their physical health may well outweigh any risks. This is never the case in cosmetic surgery. By definition, it is not medically essential. Thus the patient alone must choose whether they wish to expose themselves to the risks of their procedure. Some patients find it difficult to translate numerical probabilities into factors that affect their decisions on a daily basis. For example, people who truly appreciate the chances of winning the lottery don't waste their money on a ticket!

Most of the complications that are described here only happen to a very few, unlucky patients. Indeed, cosmetic surgery is safer and more predictable than conventional surgery, mainly because the patients are healthy — or should be — before the operation. Serious post-operative complications are rare and, if they do occur, further surgery will often rectify or improve the result.

In order to appreciate why complications are unpredictable or indeed occur at all, we must appreciate that every human being has a unique genetic profile. Our genetic profile ultimately controls our health and the way we react to a given set of outside influences or stimuli. It also controls the way our healing process reacts and behaves. Flaws can sometimes occur in the healing process and can predispose to a poor result.

Scars

All surgical incisions heal by producing a scar. To make scars less obvious the surgeon tries to make any necessary incisions where they will not easily be seen, such as in natural skin folds or inside the hairline. It is wrong to think that scars will be invisible or that they will completely fade to nothing in time. The term 'invisible scar' should never be used. Wound healing is an extremely complex, biochemical process involving many variables. For this reason the final results of healing cannot be accurately predicted.

Once an incision is made and sutured (stitched) the surgeon has little control over the healing process.

Most scars will look worse (red and raised) for some time after the operation before they mature and become pale and level with the surrounding skin. In general, scars take six to 18 months to mature (in some cases, they can take longer). There will always remain a permanent mark, no matter how inconspicuous, where an incision has been made.

In some situations scars can heal unfavourably in certain people. Scars may become infected, stretched or thickened (hypertrophic or keloid) and may necessitate further treatment eg. steroid injections or scar revision to improve the Final cosmetic appearance. Even in someone who has never had a history of unfavourable scarring, the unexpected can occasionally happen and mar an otherwise good result.

Some areas of the body and some skin types are notorious for producing worse scars than others eg. over the breastbone. Where an incision is sutured under tension there is a good chance that the scar will stretch, for example, in abdominoplasty.

If a ten-centimetre incision is made on the forearms of 100 individuals and sutured in exactly the same manner, the final outcome after two years would give a variety of results. At one end of the scale the scar would be almost invisible. At the other, a thickened, raised and red hypertrophic or keloid scar would result This simple example also applies to more complex procedures; unfortunate healing such as this can thus give an unfavourable result to a procedure that has been otherwise expertly performed.

Infection

Infection can occur after any surgical procedure. Most commonly the wound (incision site) is affected. If the infection progresses, the adjacent and surrounding tissues can become affected. This condition is known as cellulitis. Further progression of the infection may lead to formation of a localised deep pocket of pus or abscess formation.

Fortunately, infection in cosmetic surgery is not common and is easily treatable, usually with antibiotics, rest and local hygiene measures. Abscess formation must be more vigorously treated, often necessitating further surgical intervention in the form of a drainage procedure. Abscess formation is extremely rare but can occur following some cosmetic procedures, such as breast surgery, abdominoplasty and liposuction.

Sometimes chest infections occur after surgery, especially in smokers and patients with previous chest or breathing problems.

Finally it must be mentioned that MRSA (methicillin resistant staphylococcus aureus or 'superbug' as it is labelled by the press) is increasingly becoming the scourge of our hospitals. If an MRSA infection is diagnosed, it can be extremely difficult to treat. It is rare in previously healthy patients who only spend a short time in hospital, which is the usual situation in cosmetic surgery.

Bruising and Swelling

This is the body's natural response to injury. Every surgical procedure is followed by a period of bruising and swelling, depending on the nature and extent of the surgery.

In general, the more expert and adept a surgeon is, the less post-operative bruising and swelling will result. This is because an experienced and slick surgeon will perform an operation or procedure with the least amount of imparted trauma to the tissues.

The patient's response to trauma is also an important part of the equation. Some people bruise more easily than others and this can be caused by variations in the fragility of their blood vessels and the levels of blood coagulation (clotting) factors. Most elderly people have more fragile blood vessels than the young. Low levels of blood coagulation factors can run in families, even without obviously diagnosable bleeding disorders.

Although there has been much controversy about its effectiveness, many surgeons recommend a course of arnica tablets both before and after surgery to help reduce bruising and swelling and to enhance the healing process.

Pain and Discomfort

Following any surgical procedure the patient will experience a degree of pain and discomfort. Although research has given us an increased understanding of the mechanisms of pain and its perception by the human body, the best we can still do is to give appropriate medication in an attempt to alleviate or reduce pain, especially in the immediate post-operative period.

The degree and duration of post-operative pain will depend on the nature of the operation and the patient's pain threshold. Little can be done at present to alter an individual's pain threshold. The standard painkilling injections and tablets usually suffice to alleviate this unpleasant sensation to a tolerable degree.

It is therefore extremely difficult if not impossible to describe accurately to patients beforehand the degree and duration of their post-operative pain.

Deep Vein Thrombosis

This complication is rare in patients undergoing elective cosmetic surgery. Deep vein thrombosis (DVT) results when a blood clot develops in one or more deep veins in the calf. It is possible for the clot to become dislodged from its origin in the calf and be transported by the bloodstream to the lungs (pulmonary embolus) where it can have very serious consequences. Patients with a previous history of post-operative deep vein thrombosis should warn the surgeon and the anaesthetist before the operation.

Women taking oral contraceptives may run a slightly increased risk of developing a deep vein thrombosis after some operations. There is some controversy about the benefit of stopping oral contraceptives before surgery. Many medical practitioners hold the view that an equal or even greater risk is incurred from the possible complications of an unwanted pregnancy upon cessation of the pill. Nevertheless, it is thought wise to stop oral contraceptives prior to certain operations. Every patient is assessed on merit before surgery and the surgeon should advise each patient accordingly.

Nowadays the best equipped hospitals and clinics have equipment that massages the calves while the patient is under general anaesthetic. In addition, it is now standard practice for all patients to wear anti-embolism stockings during and after the operation.

The incidence of DVT is very much reduced if patients resume gentle activity soon after the operation. It is not a good idea to spend several days in bed after surgery if it is possible to get up and move about. This is not to say that patients should strenuously exercise soon after surgery, as this is likely to have a very deleterious effect.

Allergic Reactions to Drugs and Dressings

Various drugs are given during a hospital stay in the ward or injected during the course of a general anaesthetic. It is important to avoid being given any drug to which you might be allergic. You must report any known allergy especially to drugs, dressings and foods to the nursing staff on admission to hospital. Severe allergic responses have to be dealt with promptly and effectively to avoid serious consequences.

Bleeding and Haematoma

Sometimes bleeding can continue after the end of the operation or restart again several hours after completion of the operation. It can either track to the surface and manifest itself as localised bruising or collect in a space or pocket deep in the skin. Such a collection of blood is called a haematoma and if it becomes large enough (expanding haematoma) it will be necessary to remove or evacuate it through a further procedure.

In certain cosmetic procedures an expanding haematoma constitutes a surgical emergency in that, if it is not treated promptly, irreversible damage to the surrounding tissue can occur. The best example of this is an expanding haematoma developing under the skin flap following facelift surgery resulting in 'flap necrosis' or death of the skin.

Drains

Sometimes small flexible tubes are used to enable collections of blood or other fluids to drain out from a wound. This reduces bruising and speeds recovery. They are removed a day or two after the operation. Modern drains are made of pliable plastic and remove easily without causing discomfort.

Problems with Urination or Urinary Tract Infection

Patients who are prone to urinary or kidney infections have an increased risk of this happening after surgery. This may be due to lying in one position for a prolonged period during the operation and its recovery, and also because drinking a lot of water is discouraged immediately before surgery.

Blood Transfusion

Blood transfusion is seldom required in cosmetic surgery. All blood is carefully screened by the blood transfusion service for any infectious agent before it is released for use.

Cosmetic Surgery and the Media

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When cosmetic surgery first started to become popular in the UK in the early 1980s it attracted very limited media coverage. Articles in magazines and newspapers were based on information from the USA and would only appear every few months. In total contrast, in the last few years a day doesn’t go by without some mention of cosmetic surgery in the media. Without doubt this surgical speciality attracts more media coverage than any other type of surgery.

Significant amounts of cosmetic surgery were done in the past, but patients tended to be quite secretive about having had it done and tried to avoid publicity. Also, there were very severe restrictions placed on doctors regarding advertising. If any doctor allowed his name to appear in print he risked being struck off and losing his livelihood. This has all changed now. Many doctors advertise openly, and some blatantly seek any publicity in order to increase their practices.

A word must also be said about the volume of advertising and advertisements in the media concerning clinics. Many clinics spend a lot of money with public relations (PR) companies to promote their services in the media. The more successful PR companies have a direct working relationship with editors of popular magazines and newspapers and can arrange for favourable articles to be published about their particular establishment. Quite often, media articles featuring wildly ecstatic patients are simply advertisements for the clinics concerned. We urge caution in believing everything you read, as there are some establishments that are extremely ruthless in the way they conduct themselves, and in our opinion they give cosmetic surgery a bad name.

It is easy to understand why the media publishes so many articles on the subject. The idea of anyone subjecting their body to physical assault in pursuit of enhancing their appearance attracts much criticism and controversy but, above all, the huge curiosity of the general public.

Nowadays, the back pages of both women’s and men’s magazines are full of advertisements for cosmetic surgery. In addition, television programmes on enhancing appearance by cosmetic surgery regularly appear on our screens.

From the point of view of the cosmetic surgeon, this media coverage is a double-edged sword. On the one hand, it increases the number of people seeking surgery, but on the other, the editorialising of many of these programmes can often lead to false hopes and ideas, making this a potential banana-skin situation for the surgeon. For this reason, most cosmetic surgeons who have been practising this speciality for many years will agree that patient expectations today are far higher than ever before.

Not all media reports about cosmetic surgery are favourable. Very often stories are incorrectly reported or overly dramatised to make them appear more unfavourable than they really are. The reason is simple. The more dramatic, controversial and unfavourable the report is, the more attention it will attract. Serious adverse incidents are, actually, very rare.

Government guidelines are now in place with respect to all medical specialities in an attempt to keep adverse incidents to a minimum. In addition, more stringent controls are being exercised regarding the suitability and qualifications of practitioners who perform these procedures. It is undoubtedly true to say that the vast majority of cosmetic operations and procedures are very successful and prospective patients should not be unduly apprehensive.

Seeking Advice - Finding a Surgeon

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The British Association of Cosmetic Surgeons (BACS) suggests that patients can find a surgeon by:

1.Contacting the British Association of Cosmetic Surgeons directly.

2.Seeking a referral from their General Practitioner.

3.Getting a recommendation from another patient.

4.Contacting a clinic that advertises to the public.

Contacting the British Association of Cosmetic Surgeons

A list of recommended cosmetic surgeons can be found on the BACS website: www.b-a-c-s.co.uk. These surgeons will all be members or associate members of the BACS.

Most surgeons also have their own websites, which can be accessed from the Association's website. Prospective patients are thus able to find out more about a particular surgeon and/or procedure before making contact.

The General Practitioner

This is the system of referral advocated by the General Medical Council (GMC). It dates back from well before the inception of the NHS, when it was considered unethical for a consultant to accept private patients unless they were directly referred by their GE This was designed to stop unscrupulous consultants touting for patients and treating them inappropriately. However, many patients wishing to undergo cosmetic surgery prefer that their GP is not informed or aware of their intentions. There are many reasons for this.

Many patients are simply too shy or embarrassed to approach their GP for fear of being ridiculed or discouraged from treatment. Some do not wish to burden their overworked GP with a problem involving an element of vanity when he is already so busy with more essential medical problems. Same patients may have already seen their GP, who told them not to have any treatment, and so they would like a second opinion. Others may have been referred by their GP to a surgeon with whom they did not have a rapport and they would like to see someone else.

Many fear that their intentions will be made public because of the nature of the referral system. This necessarily involves the GP's staff who they fear may divulge their secret to others in their community.

Some patients admit to not knowing their GP and would prefer to bypass him altogether. Others are not registered with a GP. Some have openly admitted that they have little trust or faith in their GP and would not contemplate approaching him with such a delicate, personal and private problem.

Although more and more GPs are aware of the benefits that cosmetic surgery can offer and are entirely sympathetic and helpful, there are still a number who are less enthusiastic and who strongly try to dissuade any prospective patients.

Most cosmetic surgeons get very few referrals from GPs.

Recommendation from Another Patient

This is arguably the best and surest way of being referred to a surgeon who has at least proved that he/she is competent at performing the procedure. Most surgeons who do not advertise get the majority of their new patients by referrals from their old patients.

The drawback here is that most patients will not openly or freely admit to undergoing cosmetic surgery, so a prospective patient may not know whether any of their friends and acquaintances has had any surgery.

Clinics that Advertise to the Public

In recent years there has been a huge increase in the number of clinics, establishments and so-called advisory centres offering cosmetic surgery to the public. Many such places are run by non-medically qualified persons who regard it as a quick way of making easy money.

The reason why these establishments have increased in number over the years is that, until quite recently, it was an offence for medical practitioners to advertise their services and expertise to the general public. This could result in the practitioner being struck off the medical register.

It was, however, perfectly legal for a non-medically qualified person to set up a limited company offering cosmetic surgery services. This company could employ the services of a surgeon and anaesthetist as long as their names were not made public.

Thankfully, with the changes in GMC guidelines, the public is now able to get direct access to the surgeons, and therefore have a greater choice in selecting the one they wish to perform their surgery or treatment.

The BACS advises anyone approaching a clinic that advertises to the public to make sure they see the operating surgeon at a pre-operative consultation well in advance of the day of surgery. If the surgeon is not a BACS member, they should make sure they are treated according to, or along similar lines to, the BACS Code of Practice. In addition, it is important to find out about the surgeon's experience, qualifications, and proof of previous procedures performed (eg. pre and post-operative photographs of the surgeon's work, although it would be extremely difficult to prove beyond doubt that these were in fact photographs of his/her work), and to see as many testimonials from previous patients as possible.

It should be recommended that patients only be seen by the operating surgeon and not by any other party. Many clinics employ so-called 'counsellors' — often non-medically qualified sales people — to entice people into undergoing surgery. We strongly feel that such a practice is dangerous and can easily lead to patients being given misleading information, which can cause problems later on. Cosmetic surgery is a very personal and private undertaking and depends on a good patient-doctor relationship, without the involvement of any other party. Some commercial clinics are indeed well run and employ competent surgeons who successfully carry out a large number of cosmetic operations.

The BACS Code of Practice

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Before admission to the Association each member must agree to abide by the Association's Code of Practice at all times. The Code does not purport to be a complete Code of Ethics of conduct and the Council of the Association specifically reserves the right to amend the code as and when it deems appropriate.

1.All patients seeking cosmetic surgery will receive thorough and meticulous pre-operative counselling with full information both verbal and written as is necessary for a full understanding of the procedure and its complications. In addition, patients will be asked to confirm in writing that they have received and understood such information.

2.The surgeons must use their best endeavours to make sure that if non-medically trained counsellors (or any other counsellors who are not members of the medical profession) are imparting advice to patients, then that advice must not interfere/conflict with the advice that has or may be imparted to the patient by the surgeon. The regulation applies to all pre-operative advice, post-operative advice and treatment. Where the surgeon becomes aware that there has been any interference/conflicting advice, then he/she must take immediate steps to re-affirm his/her advice to the patient.

3.Adequate time should be allowed between pre-operative consultation and the operation in order to give the patient every opportunity to consider carefully all the facts pertaining to treatment.

4.The Association recognises that adequate time may vary depending upon the type of surgery requested. The Association recognises that some patients may wish to have the operation on the same day as the consultation and, if this is the case, then the patient shall be asked to sign a form stating that the Surgeon has recommended that there should be an adequate lapse of time between the consultation and the operation, that the patient has understood the advice and has instructed the Surgeon to proceed on the same day as the consultation.

5.In circumstances whereby the Surgeon becomes aware that a patient may require an operation on the same day as the consultation then he/she must use his/her best endeavours to send to the patient all relevant information and literature pertaining to his/her operation/ treatment, some time before the consultation.

6.Surgery must only be performed in places that are properly equipped and staffed for such surgery. There are some clinics and organisations recommended by BACS, and Members must not carry out cosmetic surgery in clinics or organisations that are not on the recommended list. The list is constantly reviewed and updated and a Member may approach the Council at any stage and ask for a particular organisation/clinic to be placed on the recommended list. Provided three Members of the Council approve then that organisation/clinic will be added to the recommended list.

7.All members must ensure that any literature/documentation that he/she would normally impart to his/her patients relating to the Surgeon's speciality is constantly reviewed and, where appropriate, updated. All members will, pursuant to a written request from the Council, produce copies of the aforementioned literature/documentation for inspection by the Council within 14 days of a written request.

8.All members must only perform cosmetic surgery in the approved module(s) for which they have been admitted as Members of the Association. If a member wishes to extend his Membership to cover any other approved cosmetic surgery module in respect of which he/she has not been admitted as a Member then he/she must make the appropriate application to the Membership Committee to extend his/her category of Membership.

The British Association of Cosmetic Surgeons (BACS)

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Cosmetic surgery is a relatively new surgical speciality in the UK and is not readily available in the National Health Service (NHS). Up until quite recently there was relatively little interest in this speciality. It was even frowned upon by many medical practitioners who regarded cosmetic surgery as unnecessary and frivolous.

Because there was little to offer in the way of surgical expertise in cosmetic surgery in the late 1970s and early 1980s in the UK, a group of surgeons, from various surgical specialities, inaugurated the British Association of Cosmetic Surgeons (BACS) in 1980. What united them was their interest in cosmetic surgery as a speciality in its own right.

The British Association of Cosmetic Surgeons was established to promote the study and practice of cosmetic surgery, to act as a forum for the exchange of information and ideas among its members and to promote and maintain the highest standards in this speciality. The Association has a defined Constitution as well as a strict Code of Practice, which all members must abide by at all times.

The Association has grown over the years but has never lost sight of its initial aims. The entry criteria, which have to be satisfied by all new members, are strict, and membership is an honour. Full membership is only granted to those who are Fellows of one of the Royal Colleges of Surgeons (FRCS), or hold the equivalent European qualification and have proven competence in cosmetic surgery. Competence is assessed by already established members of the Association who report their findings and opinions to the membership for final approval before admission to the Association.

In recent years the Association has opened its membership to include Associate Members. Associate Members are qualified medical practitioners but do not necessarily hold the same qualifications as Full Members. These practitioners engage in the regular practice of cosmetic procedures, but often those less complex than those performed by full members eg. hair transplantation, laser skin surgery or thread vein treatment.

The Association holds regular clinical meetings and encourages members to travel widely to attend seminars and conferences to keep up to date with progress in this speciality. All surgeons have to audit their work and undergo regular revalidation under the auspices of the General Medical Council and Royal Colleges.

We would stress that the British Association of Cosmetic Surgeons is not the only association or group of medical practitioners that practice cosmetic surgery in the UK. The British Association of Cosmetic Surgeons was however the first group of surgeons to be established in the UK, whose main dedication was to enhance the practice of cosmetic surgery and whose members performed cosmetic surgery full-time. There are other groups of surgeons and doctors, generally drawn from narrow fields, such as Ear, Nose and Throat (ENT), Maxillofacial and Plastic Surgery.

The Pre-Operative Consultation

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The results of cosmetic surgery can be very gratifying to both the patient and the surgeon. Before you have any treatment, a consultation with the surgeon should take place, involving a full discussion without any obligation. All your questions should be answered satisfactorily and you should be given time to think over what has been said and what has been proposed.

In an ideal world, cosmetic surgery should consist of two parties only: you and the surgeon. After all, it is the surgeon who has the task of determining your expectations, performing the operation or procedure, looking after you post-operatively and taking full responsibility for all post-operative problems, complications or unfavourable consequences.

Without doubt, the single most important stage in any cosmetic surgical procedure is the pre-operative consultation. It is at this stage that all the necessary parameters are laid down. In addition, both you and the surgeon should form an amicable relationship based on honesty, integrity and trust. If such a relationship is not formed at this stage it is better in the long term for you to seek help elsewhere or for the surgeon to decline treatment because the likelihood of an outcome unsatisfactory to you is very much increased.

A consultation is essential because the surgeon also has to ask you about your past medical history in order to find out if there are any details that might influence an operation. When the surgeon knows more about you he is then in a better position to operate effectively and safely. The surgeon will normally communicate with your GP after the consultation, as long as you have given him permission to do so.

At the initial consultation the surgeon has a duty to decide if you have a problem that can be improved by an operation. Sometimes your feelings about what you look like are very different from what other people see. The best results in cosmetic surgery are obtained when the surgeon and the patient agree about the problem in the first instance. Then the surgeon has to ask himself whether there is an appropriate treatment that will improve it. It is obviously pointless to undertake a treatment that might not work or might even make things worse. In order to be successful, an operation has to be performed on the right person using the right technique.

Once the surgeon has decided that there is a treatment that will work, he should inform you fully about the operation and the post-operative course of events, such as when the stitches are removed and when you can expect to be 'presentable' again after the operation.

Cosmetic surgery is not invisible. But, by careful operative technique and the accurate positioning of the incisions, the scars can be almost invisible and only detectable on the closest examination. Patients on their part should realise that some skin heals better than others. This, of course, should be fully discussed in the initial consultation – as should all likely complications.

The more you know about the operation because everything has been carefully explained to you, the more likely you are to be pleased with the result. This initial consultation can take up to an hour, in order for the surgeon to tell you enough about the operation for you to be able to make a valid decision. The initial consultation is a mutual process: both you and the surgeon will be trying to assess each other. You will be trying to decide whether to allow the surgeon to treat you. Most surgeons these days hand out printed information sheets that can be studied carefully later.

There are three criteria that are important in this assessment process:

Does the surgeon understand the problem? Did he make the appropriate responses when you explained the problem? Understanding the patient's problem is vital, because if the surgeon never quite empathised with the patient, a successful outcome would be a fluke. You need to consider whether the treatment proposed by the surgeon is actually what you are seeking and whether it is relevant to your problem.
Did the surgeon prove to you that he can do something about it successfully? At consultation, most surgeons show photographs of previous patients, which should give you a good idea of what the surgeon is likely to achieve. You should ensure that the photographs are relevant to your own case If you are unconvinced by the photographs of the surgeon's previous patients, you should not go ahead.
Has anything put you off from wanting to be a patient of this particular surgeon? Sometimes the photographs reveal that the surgeon's and your ideas of what would be a successful result are radically different. Your judgement should not be solely determined by the reputation and qualifications of the surgeon. Not all surgeons are right for all patients and vice versa. To have a cosmetic operation performed by any particular surgeon is a very personal choice. It is important to establish a good rapport. If you are put off for any reason you should seek another surgeon.

The surgeon's job at the pre-operative interview is simpler. There is only one criterion: whether he thinks you are going to be pleased if you have the proposed treatment. If the surgeon feels that there is a significant risk of disappointment then he would be unlikely to offer it.

Of course, you may decide not to go ahead after hearing all about the operation. The consultation will still have been very valuable and saved you a lot of stress and worry — and money! There should be no pressure to come to a decision at the consultation itself. On the contrary, difficult decisions, such as deciding whether to have an operation or not, must not be rushed.

Most surgeons will offer you several consultations, anticipating that you will often only think of important questions that you wish you had asked after you have given the matter a good deal of thought. Some patients may wish to book their surgery at the initial consultation in a wave of enthusiasm, only to regret it later. Commercial clinics and greedy surgeons have certainly put pressure on patients to decide quickly and have offered inducements to do so. This is extremely unprofessional practice.

The surgeon himself should of course carry out the initial consultation, the surgery and all the post-operative care, and should be available to you at all times during the treatment process.

Some surgeons use computer imaging to illustrate or emphasise possible results or outcomes of surgery. This technique may work well and be successful for some surgeons and patients. Neither of us adopt this practice routinely, because we are only too aware that it is not always possible to accurately match the final long-term post-operative appearance of a part of the body by simply editing features on a computer screen. The human body does not always comply with the before and after pictures illustrated by computer graphics for reasons already explained. We therefore urge extreme caution to all patients who have experienced a consultation where computer imaging was used — the result shown may not necessarily match the result achieved by surgery.

It is a sensible idea to see a number of surgeons before going ahead with an operation. This makes it much easier to assess individual surgeons against each other, and to decide which surgeon would be most appropriate for you.

It cannot be stressed enough that the pre-operative consultation appointment is perhaps the most important part of the whole process of undergoing a cosmetic surgical procedure. The relationship between the patient and surgeon is of the utmost importance. To make the point again: beware of establishments that offer the services of such people, and no other adviser, so-called counsellor or any other party should interfere or be involved in the counselling stage.

Cosmetic Surgery Advice

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Looking for cosmetic surgery advice about cosmetic surgery treatments? Then you've definitely come to the right place.

Cosmetic surgery treatments or procedures are capable of achieving almost totally unbelievable outcomes. Cosmetic procedures have certainly never been so sought-after and widely available as it is now, possibly because celebrity recommendation and endorsement has put the concept at the top of the wish list for everyone, not merely the rich and famous, but for average men and women also.

Nevertheless, regardless of whether you might be considering a straightforward Botox® procedure in order to iron out facial lines and wrinkles, a liposuction procedure to help alleviate problematic areas of excess fatty tissue, or possibly a much more significant procedure on your breasts or your face, a cosmetic surgery treatment should for no reason, ever, be undertaken lightly.

When an individual's anticipations are unrealistically high or maybe when an inexperienced cosmetic surgeon, employed by a less respected treatment clinic, is allowed to operate on an a naive member of the public, disappointment or maybe even a problem may occur.

It is crucial that the appropriate surgical treatment is performed for the best reason, on a suitable patient, by the perfect cosmetic surgeon. It is also essential that adequate time is dedicated to pre-operative counselling, in order that knowledgeable permission is granted in order that the patient is completely mindful of what to expect.

Cosmetic surgery advice is important to receive a thorough review of everything any individual considering a cosmetic surgery treatment or procedure will ever need to know; not only a fundamental comprehension of the benefits and dangers, but an in depth explanation - in simple English - of the specific procedures themselves.

We, all of us, inhabit a world whereby the majority of media coverage on the subject matter is usually either journalistic hype, business advertising or even outright scare-mongering and it is not easy to determine what to believe.

Discovercosmeticsurgery.com is a unique website. It is the website you can most certainly believe, which is a fundamental read for every woman or man considering cosmetic or plastic surgery treatments, and who needs accurate advice.

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1. Cosmetic surgery advice

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Where is Breast Implants Surgery Performed?

2010-11-10T07:04:00.001-08:00

Breast implants surgery can be carried out in a variety of different places.

Numerous diagnostic surgical treatments can be performed within an outpatient environment, as can breast enhancements, breast augmentations, lumpectomy, breast lifts, plus some breast reductions. Significant breast reductions as well as any form of breast reconstruction should be carried out in a medical center or ambulatory surgical facility that has suitable accommodation where one can spend the night time recuperating.

The Breast Cancer Patient Protection Act of 2004 demands insurance companies to pay for a minimum forty-eight hour hospital stay for patients undergoing a mastectomy.

Whether your own breast implants surgery procedure is going to be in a hospital setting, ambulatory surgical facility, or medical center, make certain the facility where breast implants surgical treatment is performed is actually fully accredited by a nationally recognized organization and/or is actually state licensed. This is necessary to ensure your safety.

In the year 2003,the American Society of Plastic Surgeons documented that sixty percent of aesthetic procedures were carried out in office--based medical facilities, twenty-eight percent had been done in a hospital environment, and sixteen percent within free-standing medical facilities. This included breast implants surgery along with other plastic surgery procedures.

Accreditation means an out-patient setting or hospital or surgical facility that has passed state regulations or national regulated requirements, not only for medical equipment, but also for architecture, procedural protocols and inspection. It must also strictly adhere to national, state and local regulations for sanitation, building codes and fire safety.